Blue Peacock Acupuncture LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

BLUE PEACOCK ACUPUNCTURE LLC

Practice address

4007 Bridgeport Way W Ste C
University Place, WA 98466-4330

Phone

(253) 242-3661

NPI assigned

Apr 24, 2024

Last updated

May 22, 2024By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Erin Dietz, LACNPI 1356501563

Title

Owner/Practitioner

Phone

(206) 351-5922

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Erin Dietz, LAC

  • Acupuncturist
  • University Place, WA
  • NPI 1356501563
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1713916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1716336000000",
    "number": "1508612292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5319 S JUNETT ST",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984096334",
            "telephone_number": "206-351-5922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4007 BRIDGEPORT WAY W STE C",
            "city": "UNIVERSITY PLACE",
            "state": "WA",
            "postal_code": "984664330",
            "telephone_number": "253-242-3661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE PEACOCK ACUPUNCTURE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-24",
        "last_updated": "2024-05-22",
        "certification_date": "2024-05-22",
        "status": "A",
        "authorized_official_last_name": "DIETZ",
        "authorized_official_first_name": "ERIN",
        "authorized_official_title_or_position": "OWNER/PRACTITIONER",
        "authorized_official_telephone_number": "206-351-5922",
        "authorized_official_credential": "LAC"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christine Blackburn, FNP-C
• Timothy Earl Blair
• Ahmear T Bland
• Kyle Travis Blevins, RN
• Blue Mountain Behavioral Health PLLC
• Bluestone Wellness PLLC (Bluestone Wellness)
• David D Bluhm, CST
• Bodywise Massage Inc
• Richard Bohnemann, PA-C
• Ashley Bond

• Clinic/Center in University Place, WA
• Providers in University Place, WA by specialty
• Clinic/Center in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.